To assess the effects of Byakko-ka-ninjin-to on thirst and body weight gain in chronic hemodialysis patients with excessive interdialytic body weight gain, 8 patients (4 men and 4 women, ranging in age from 47 to 75) were prescribed Byakko-ka-ninjin-to extract tablets, 6-12 tablets per day, for 10 weeks. In 4 of the patients, thirst symptoms improved, resulting in significant reduction of interdialytic weight gain. This effect continued to be significant even after cessation of the agent. In the cases of 4 patients whose thirst symptoms did not improve, interdialytic weight gain was not reduced either during or after treatment. For all 8 patients, there were no significant changes in cardiothoracic index, and no adverse effects or events were observed either during or after treatment. Significant reduction in interdialytic weight gain was observed only in the patients with reduced thirst, which suggests that Byakko-ka-ninjin-to allows patients to limit their weight gain by drinking less. These results suggest that Byakko-ka-ninjin-to could be a useful and safe agent to reduce excessive interdialytic body weight gain, at least in a significant cohort of chronic hemodialysis patients.

Six male and seven female children, aged five or six years, ran on the flat treadmill increasing running speeds every two minutes by 20 m/min till their subjective exhaustions. The first steps were started with the speeds of 80 or 100 m/min and the rest periods of 30 seconds were inserted between each successive step for the blood sampling. Expired airs for the determination of oxygen uptakes were collected during the last 30 seconds of every stage. Heart rates were recorded for each subject throughout the whole test session.
Two male and two female subjects were selected in order to determine their physical activity levels in the nursery school. Their heart rates were recorded from Monday to Saturday in a given week.
Analyses of physical activity patterns were tried by relating heart rate levels to circulorespiratory variables which were equivalent to 3 or 4 mmol/l blood lactate concentration (3m MLA or 4m MLA) .
By so doing, the following results were obtained:
1) Mean values of blood lactate concentrations observed immediately after the cessation of the last exhaustive steps were 5.16 m MLA for males and 4.70 m MLA for females.
2) Relative values of heart rate to 3 and 4 m MLA against maximal heart rate (% HRmax-3 m MLA and % HRmax-4 m MLA) were respectively 92.2% HRmax-3 m MLA and 97.5% HRmax-4m MLA for males and 94.9% HRmax-3 m MLA and 98.2% HRmax-4 m MLA for females.
The corresponding relative values of oxygen uptakes were 85.2% Vo₂max-3 m MLA and 94.3% Vo₂max-4 m MLA for males and 89.7% Vo₂max-3 m MLA and 96% Vo₂max-4 m MLA for females.
3) Mean values of heart rate recorded in the nursery through a given week except Sunday ranged from 89 to 114 beats/min for males and 106 to 126 beats/min for females. In the relative value of a heart rate against the heart rate equivalent to 4 m MLA, that is, HR 4 m MLA these values correspond to 44-57% HR 4 m MLA and 57-67% HR 4 m MLA respectively.
4) Accumulated duration time: Their hearts beat higher than 160 beats/min, except in the case of 800 m endurance run (only 0-4 and 0-6 minutes for males and 0-6 and 4-21 (touch of tachycardia) minutes for females) .
Percentages of accumulated duration time lower than 120 beats/min occupied 72-94% and 77-91% of 6 or 7-hour nursing time for males and 51-91% and 51-78% for females.
5) Absolute and relative values of mean heart rates in 800 m endurance run ranged from 183 beats/min (Net 83% HRmax, 90% HR 4 m MLA) to 199 beats/min (Net 98% HRmax, 104% HR 4 m MLA) for males and from 172 beats/min (Net 77% HRmax, 92% HR 4 m MLA) to 196 beats/min (Net 92% HRmax, 96% HR 4 m MLA), though the duration times were short.
6) Optimal intensity of work load was proposed to be the heart rate level of at least 190 beats/min for favourable development and/or improvement of the circulo-respiratory system in young children.

Twelve young boys as an experimental group and seven as a control group, aged 5-6 years, participated in a study to clarify whether circulorespiratory trainability exists in young children. The subjects in the experimental group performed a 915 m endurance run on an agricultural road every day except Sundays for six months. During the run, heart rates (HR) equivalent to 3-4 mmol⋅l^-1 of blood lactate concentration (LA) were maintained for at least 3-4 min⋅m^-1. The control group was given no special training.
Before and after the training period, both groups were subjected to increased stepwise running velocity on a flat treadmill till subjective exhaustion to determine circulorespiratory variables such as heart rate (HR), oxygen uptake (Vo₂) and blood lactate concentration (LA) at all steps.
From the above mentioned procedure, the following findings were obtained :
1) After the 6-month endurance run training, Vo₂max/TBW was significantly (p<0.05) increased from 47.5 to 50.4 ml⋅kg^-1⋅min^-1 and also the peak LA was significantly (p<0.05) increased from 5.41 to 6.36 mmol⋅l^-1in the experimental group. On the other hand, no significant increases were observed in the control group.
2) Running velocity in the final stages (Vmax) was significantly (p<0.001) improved from 190.0 to 205.0 m⋅min^-1in the experimental group. Such effects were due partly to the improvement of circulorespiratory function and partly to improved efficiency of running motion. However, no significant differences were found in the control group.
3) Submaximal V, HR, and Vo₂/TBW equivalent to 3 and 4 mmol⋅l^-1 and their values relative to the maximum values showed no significant differences before and after the training period in both groups. The improvement of maximal circulorespiratory variables observed in the experimental group suggests the existence of trainability even in young children.

Abnormal lipid metabolism associated with various renal diseases has been known for a long time. Hypercholesterolemia is one of the characteristic features of nephotic syndrome, and hypertriglyceridemia is often observed in chronic renal failure (CRF). The role of lipid abnormalities in the pathogenesis of renal diseases has been variously discussed. However, direct evidence only recently became possible when more sophisticated analyses of renal histopathology as well as an application of molecular biology were introduced in the field of clinical nephrology. The recent identification of lipoprotein nephropathy (LPG), reported most often by Japanese authors since 1989, is particularly noteworthy. The detailed analysis of lipid profiles and renal histology has been instrumental in clarifying the relationship between lipids and the kidney not only in LPG but also in other disease entities such as familial-type dyslipidemias, CRF, focal glomerulosclerosis, and diabetic nephropathy. Dyslipidemias common to these diseases, together with the presence of hypertension, cause systemic atherosclerotic lesions (including lesions in the kidney) and terminal renal failure.
seconds ; Kidney Diseases ; lipid metabolism ; Abnormal ; Lipids

In order to find out the criteria for the determination of maximal oxygen uptakes of very young children, five boys and five girls, aged four or five years, served as the subjects. They ran on the horizontal treadmill once a day for the constant three minutes on different days. The velocity was increased from the first 100m/min by 20m/min till the last where they could endure no longer for the three minutes. As the consequence, the velocities attained were 100m/min, 120m/min, 140m/min, 160m/min, 180m/min and 200m/min for boys and 100m/min, 120m/min, 140m/min, 160m/min and 180m/min for girls.
The expired airs were collected at rest and whole through the treadmill running.
Heart rates were also continuously registered not only at rest but also during the treadmill running.
The following results were obtained:
1) At the velocities of 100m/min, 120m/min and 140m/min apparent steady states of heart rates and Vo₂ were established within the three miuntes both for boys and girls.
But boys showed lower heart rates and higher Vo₂ during the steady states at a given velocity than girls did.
2) At the last velocity of 200m/min Vo₂max were attained 30 seconds after the start of running for boys and also at the last of 180m/min girls reached Vo₂max 60 seconds after the beginning.
It was, therefore, confirmed that if the work intensity was sufficiently high, Vo₂ max could be reached at the latest between 30 and 60 seconds after the start of work for young children.
3) At the one step lower velocity than the last, namely, 180m/min for boys and 160m/min for girls, the plateaus of Vo₂max were found for the last minute.
4) The heart rates simultaneously observed with Vo₂max ranged from 202.4 to 206.4 bpm and also RQ were all above the unit. Accordingly these values could be regarded as the most important critieria for the evaluation of aerobic work capacity of young children.
5) When the velocity was high, the respiratory frequency sharply rises immediately after the start of running. For the first thirty seconds the breath rates reached 60 to 90/min.
6) If the duration of the running on the horizontal treadmill are constantly fixed three minutes, the upper limit of the velocity where the safe aerobic steady state can be established is 140m/min both for boys and girls.

[Objective]In clinical practice, it is important that patients experience symptomatic improvement or at least gain a certain level of satisfaction early on during a series of treatments. Most patients decide whether or not to return to the clinic based on these factors. At our school, students are trained in protocols from three different treatment styles:modern acupuncture, meridian acupuncture (based on classic acupuncture) and traditional Chinese medicine. In this study, we investigated the characteristics of each style, such as the presence of immediate effects and the types of sensations perceived by patients.
[Methods]Questionnaires were given before and after treatment to 177 patients who came to the clinic associated with our teacher training course for acupuncture, moxibustion and massage. We received valid responses from 169 patients. The practitioners surveyed were second-year students who had treated the surveyed patients 1.2 times on average prior to answering the questionnaire. Before treatment, patients were asked about their main complaints and symptoms, and afterward about changes in their symptoms, satisfaction level and other sensations. The resulting data was subjected to statistical analysis.
[Results]The style chosen by most practitioners was modern acupuncture, followed by meridian acupuncture, and then traditional Chinese acupuncture. Most lower back, leg and joint pain was treated with modern acupuncture protocols, while internal disorders were more often treated with meridian acupuncture or traditional Chinese acupuncture. All three styles were able to alleviate symptoms and achieve patient satisfaction with no statisticallysignificant differences among the three groups.
[Discussion]The results demonstrated that training practitioners in these three styles for one year helped them achieve positive and immediate effects. While there are many different styles of acupuncture, in actual clinical practice, the style is less important than how much a patient feels the effect of the treatment.
[Conclusion]All three styles, modern acupuncture, meridian acupuncture and traditional Chinese acupuncture, were able to alleviate symptoms and achieve patient satisfaction with no statistically significant differences among them.

Protein C (PC) deficiency is an inherited thrombotic disorder with a prevalence of 0.19% among the general population. PC deficiency is associated with an increased risk of thrombosis when other risk factors are present, such as trauma, surgery, or infection, and is an important cause of mechanical valve thrombosis. We performed tricuspid valve replacement with a 29mm Carpentier-Edwards Perimount valve in a 20-year-old man with PC deficiency. The patient had corrected transposition of the great vessels with severe tricuspid insufficiency, as well as a history of cerebral infarction. In the perioperative period, we used only heparin sodium as the anticoagulant. When we restarted administration of warfarin, changing over from heparin, transient increases of serum plasmin inhibitor-plasmin complex (PIC) and thrombin antithrombin complex (TAT) levels were observed. Despite an increased dose of heparin, an appropriate activated partial thromboplastin time (APTT) was not obtained. This suggested a hypercoagulatory state, but the postoperative course was uneventful. Management of perioperative anticoagulation, prevention of late thrombotic events, and prosthetic valve selection in this particular situation are discussed.

Medical students must have knowledge and skills related to medical informatics, including data analysis, the retrieval of biomedical literature, the creation of presentations, and the use of the Internet.The purpose of this study was to analyze the changes over time in the ability of Jichi Medical University students to use the tools of information technology.
1) Questionnaires were distributed to all Jichi Medical University students during epidemiology classes in 1998, 2002, and 2006.
2) The questionnaires included questions about the frequency of the use of computers, word-processing software, spreadsheet software, statistical software, and the Internet.
3) The first survey showed that ownership of a computer and the use of word-processing software were most common, followed in turn by the use of spreadsheet software, statistical software, and the Internet.The percentage of stu dents who had not used a computer decreased from 22% in 1998 to 2% in 2006.
4) With the rapid changes and progress in our information-oriented society, medical students need to be appropriately prepared to make optimal use of available resources.

A study was performed to evaluate the physical exercise characteristics of 29 Japanese elite judo athletes by treadmill exercise test. Functional aerobic impairment (FAI), heart rate impairment (HRI) and peripheral circulatory impairment (PCI) in the judo athletes were not significantly different from those of normal sedentary subjects. However, myocardial aerobic impairment (MAI) was lower than in normal sedentary subjects. %VO₂max at the anaerobic threshold (AT) was 57.5±3.3% in male, and 57.0±4.3% in female judo athletes. %HRmax at AT was 72.4±3.8% in males, and 75.2±5.3% in females.
These findings suggest that functional aerobic capacity and peripheral circulatory function in Japanese elite judo athletes are not significantly different from those of normal sedentary subjects, but that judo athletes have high left ventricular function.
The blood biochemical profile and urinalysis date revealed that values of muscle injury enzymes, plasma uric acid and cholesterol were increased with relatively high freqency in elite judo athletes. Similar data were also obtained in individuals with suspected diabetic nephropathy and rhabdomyolysis.

BACKGROUND: The existence of a gap between research evidence and clinical practice has been described recently. Several drugs are effective in preventing secondary events after acute myocardial infarction (AMI), but it is not certain whether this evidence is employed in daily practice. We investigated the drugs currently employed for patients with a history of AMI in Japan.
METHODS: Medical records of patients who developed AMI during the calendar year of 1999 were retrospectively identified at three teaching hospitals in Japan. We collected data on drugs prescribed at three time points (upon admission for AMI, at the time of discharge, and one year after discharge) for each patient.
RESULTS: Data were available for 149 patients with AM!. Drugs prescribed at the time of discharge were aspirin (77.5%), nitrates (68.3%), and angiotensin converting enzyme inhibitors (52.8%) . β-blockers were prescribed for only 12.0% of patients. The drugs used one year after discharge were to a large extent similar to those at the time of discharge. There were no significant correlations between the use of these drugs and comorbidity.
CONCLUSION: Despite established evidence that β-blockers offer benefits to patients with a history of AMI, they have not been prescribed frequently, for reasons that remain unclear. To improve the quality of clinical care, further systematic effort is needed to bridge this evidence to practice gap.